function and more stability because of greater surface area of attachment to

Function and more stability because of greater

This preview shows page 24 - 26 out of 107 pages.

function and more stability because of greater surface area of attachment to the adjacent teeth. A fixed passive appliance that doesn’t use bands and is eas- ily placed is called a splint. Here, an orthodontic wire is bent chairside and adapted to teeth adjacent to the prematurely lost tooth. The adjacent teeth are etched, sealant applied, and a resin bonding is placed on top of the ends of the ortho- dontic wire to hold the orthodontic wire in place. This is allowed to set up and is then finished and polished. It represents an easy and rapid method to achieve space maintenance. If teeth are missing on both sides of an arch in the mandible (lower jaw), a lingual arch can be used. This is also known as a lower lingual holding arch (LLHA). Here, bands are fit on both six-year molars, and an impression is taken. An ortho- dontic wire is welded to the lingual aspect of the bands. It
runs along the lingual portion of the arch towards the lingual surfaces of the mandibular incisors. Contact with the inci- sors is imperative, because it’s this contact that enables the appliance to hold the lower molars in their original positions. The lingual arch, band and loop, and band and bar hold portions of the arch space so that posterior teeth can’t move forward and anterior teeth can’t move backward. This saves the space left by the premature loss of the primary teeth. In the upper arch, a nance holding arch can be used, which is very similar to a lingual holding arch with the exception that instead of contacting the lingual aspect of the incisors, a small acrylic button is incorporated that touches the roof of the mouth, thus holding the molars in their position and not allowing them to drift backward. Fixed space maintainers are advantageous because they’re relatively carefree and permanently cemented in the mouth, reducing the risk of loss. They’re generally well received by the patient. A disadvantage might be that they’re somewhat difficult to construct, involving welding, and if they come loose it’s imperative to have them recemented as soon as possible to maintain the fit of the appliance. An acrylic partial denture is a removable type of space main- tainer, usually without bands. It can be active or passive. It’s commonly used with prematurely missing anterior teeth. Not only does it hold space for the eventual eruption of the permanent tooth, but it also provides a more pleasing appearance. This often gives the patient more motivation to wear the appliance constantly and not lose it. The possible loss of a removable space maintainer is one of its disadvantages. Another is that it may break when not in the mouth. It also requires care and cleaning; the patient must remove it and brush it thoroughly on a regular basis.

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture